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Kaposi Sarcoma Risk in HIV-Infected Children and Adolescents on Combination Antiretroviral Therapy From Sub-Saharan Africa, Europe, and Asia

2016; Oxford University Press; Volume: 63; Issue: 9 Linguagem: Inglês

10.1093/cid/ciw519

1537-6591

Eliane Rohner, Kurt Schmidlin, Marcel Zwahlen, Rana Chakraborty, Gary Clifford, Niels Obel, Sophie Grabar, Annelies Verbon, Antoni Noguera‐Julián, Intira Jeannie Collins, Intira Jeannie Collins, Norbert H. Brockmeyer, Norbert Brockmeyer, Maria Campbell, Geneviève Chêne, Hans Prozesky, Brian Eley, Daniela Cristina Stefan, Alan Davidson, Shobna Sawry, Shobna Sawry, Mary‐Ann Davies, Azar Kariminia, Ung Vibol, Annette H. Sohn, Matthias Egger, Julia Bohlius, Frank Tanser, Michael J. Vinikoor, Eusébio Macete, Robin Wood, Kathryn Stinson, Daniela Garone, Geoffrey Fatti, Sam Phiri, Janet Giddy, Shobna Sawry, Kennedy Malisita, Brian Eley, Christiane Fritz, Michael Hobbins, Kamelia Kamenova, Matthew P. Fox, Hans Prozesky, Karl‐Günter Technau, Shobna Sawry, Robert Zangerle, Giota Touloumi, Josiane Warszawski, Laurence Meyer, François Dabis, Murielle Mary Krause, Jade Ghosn, Catherine Leport, Linda Wittkop, Peter Reiss, Ferdinand Wit, Maria Prins, Heiner Bucher, Caroline Sabin, Diana M. Gibb, Gerd Fätkenheuer, Julia del Amo, Niels Obel, Claire Thorne, Amanda Mocroft, Ole Kirk, Christoph Stephan, Santiago Pérez‐Hoyos, Osamah Hamouda, Barbara Bartmeyer, Nikoloz Chkhartishvili, Antoni Noguera‐Julián, Andrea Antinori, Antonella d’Arminio Monforte, Norbert Brockmeyer, Luis Prieto, Norbert H. Brockmeyer, Antoni Soriano‐Arandes, Manuel Battegay, Roger D. Kouyos, Cristina Mussini, Pat Tookey, Jordi Casabona, José M Miró, Antonella Castagna, Deborah Konopnick, Tessa Goetghebuer, Anders Sönnerborg, Carlo Torti, Ramón Teira, Myriam Garrido, D Haerry, Stéphane De Wit, José M Miró, Dominique Costagliola, Antonella d’Arminio Monforte, Antonella Castagna, Julia del Amo, Amanda Mocroft, Dorthe Raben, Geneviève Chêne, Intira Jeannie Collins, Norbert H. Brockmeyer, Diana Barger, Christine Schwimmer, Monique Termote, Linda Wittkop, Maria Campbell, Casper Møller Frederiksen, Nina Friis‐Møller, Dorthe Raben, Juan Berenguer, Julia Bohlius, Vincent Bouteloup, Heiner Bucher, Alessandro Cozzi‐Lepri, François Dabis, Antonella d’Arminio Monforte, Mary-Anne Davies, Julia del Amo, Maria Dorrucci, David Dunn, Matthias Egger, Hansjakob Furrer, Marguerite Guiguet, Sophie Grabar, Intira Jeannie Collins, Ole Kirk, Olivier Lambotte, Valériane Leroy, Sara Lodi, Sophie Matheron, Laurence Meyer, José M Miró, Amanda Mocroft, Susana Monge, Fumiyo Nakagawa, Roger Paredes, Lars Peters, Andrew W. Phillips, Massimo Puoti, Michael Schomaker, Colette Smit, Jonathan A C Sterne, Rodolphe Thiébaut, Claire Thorne, Carlo Torti, Marc van der Valk, Linda Wittkop, Penh Sun Ly, V. Khol, S. M. Sarun, Ung Vibol, John A. Tucker, Nagalingeswaran Kumarasamy, Suneeta Saghayam, Ezhilarasi Chandrasekaran, Dewi Kumara Wati, Luh Putu Primi Atmikasari, Imanuel Yulius Malino, Nani Kurniati, Dina Muktiarti, S. M. Fong, Michael Lim, F. Daut, Nik Khairulddin Nik Yusoff, P. Mohamad, Kamarul Azahar Mohd Razali, Thahira Jamal Mohamed, N. A. D. R. Mohammed, R. Nallusamy, Kwai Cheng Chan, Tavitiya Sudjaritruk, Virat Sirisanthana, Linda Aurpibul, Peninnah Oberdorfer, Rawiwan Hansudewechakul, S. Denjanta, W. Srisuk, A. Kongphonoi, Pagakrong Lumbiganon, Pope Kosalaraksa, Piangjit Tharnprisan, T. Udomphanit, Gonzague Jourdain, Torsak Bunupuradah, Thanyawee Puthanakit, Wasana Prasitsuebsai, W. Chanthaweethip, Kulkanya Chokephaibulkit, Keswadee Lapphra, Wanatpreeya Phongsamart, Sirintip Sricharoenchai, K. H. Truong, Quy Tuan Du, Chi Hung Nguyen, Júlio C. Viana, Hà Mạnh Tuấn, Vu An, Le Viet Nguyen, D.T.K. Khu, Anh Nguyet Pham, L. T. Nguyen, O.N. Le, Annette H. Sohn, Chuenkamol Sethaputra, D. A. Cooper, Matthew Law, A. Kariminia,

Lymphoma Diagnosis and Treatment

The burden of Kaposi sarcoma (KS) in human immunodeficiency virus (HIV)-infected children and adolescents on combination antiretroviral therapy (cART) has not been compared globally.We analyzed cohort data from the International Epidemiologic Databases to Evaluate AIDS and the Collaboration of Observational HIV Epidemiological Research in Europe. We included HIV-infected children aged <16 years at cART initiation from 1996 onward. We used Cox models to calculate hazard ratios (HRs), adjusted for region and origin, sex, cART start year, age, and HIV/AIDS stage at cART initiation.We included 24 991 children from eastern Africa, southern Africa, Europe and Asia; 26 developed KS after starting cART. Incidence rates per 100 000 person-years (PYs) were 86 in eastern Africa (95% confidence interval [CI], 55-133), 11 in southern Africa (95% CI, 4-35), and 81 (95% CI, 26-252) in children of sub-Saharan African (SSA) origin in Europe. The KS incidence rates were 0/100 000 PYs in children of non-SSA origin in Europe (95% CI, 0-50) and in Asia (95% CI, 0-27). KS risk was lower in girls than in boys (adjusted HR [aHR], 0.3; 95% CI, .1-.9) and increased with age (10-15 vs 0-4 years; aHR, 3.4; 95% CI, 1.2-10.1) and advanced HIV/AIDS stage (CDC stage C vs A/B; aHR, 2.4; 95% CI, .8-7.3) at cART initiation.HIV-infected children from SSA but not those from other regions, have a high risk of developing KS after cART initiation. Early cART initiation in these children might reduce KS risk.